| NPI | 1285355941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2103626) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.2505286) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2025-04-24 |